1. The incidence of diabetesmellitus is increasing in an alarming rate worldwide. Irrespective ofsocioeconomic status, similar trend has also been observed in India includingUttarakhand where prevalence of diabetes from 1.
2% in an ICMR survey (2008) hasgone up to 5.7% in NPCDCS survey (2012)12. Diabetes mellitus has been recognized as a risk factor for osteoporosisand fragility fracture where the underlying mechanism is yet to be defined.3. Although, WHO has defined osteoporosis with respect to Bone MineralDensity (BMD),the poor sensitivity of BMD may miss the diagnosis of manyconditions, if it is used alone.—This could be overcome by the measurement ofbone turn over markers.24. Sclerostin is an osteocytemarker and prevents osteoblast differentiation as well as bone formationthrough inhibition of WNT signaling pathway.
25. Hamann et al (2013) demonstratedthat Sclerostin antibody treatment could improve the skeletal deficits ofdiabetic ZDF rats3 Therefore, the serum Sclerostin level measurement could beuseful in DM individuals.6. A few studies have beenconducted to measure the circulating Sclerostin level in individuals with type1 4 and type 2 5 diabetes mellitus. All T2D individuals have to go throughprediabetes stage. Hence Sclerostin level measurement in Prediabeticindividuals may help in early initiation of prophylactic interventions.—thisstudy would attempt to bridge that gap of knowledge.7.
Costa et al (2013) documented thatbone turn over markers were differentially associated with Sclerostin by race6. Hence it is important to measure the circulatingSclerostin level even in Indian population, since no such study was conductedin India.8. One study 5 has shown anegative association between Sclerostin and PTH level while the other study 4has shown the opposite trend.
—This study is to resolve that issue.9. Almario and Karakas (2015) showedthat WNT signaling plays an important role in insulin resistance / secretion,inflammations and cardiovascular risk.Moreover, bone turnover may fluctuatedepending on the glucose level. Hence, better understanding of therole of WNTsignaling in prediabetic individual is essential for delaying the onset ofdiabetes and reducing the severity of bone related complications in patientswith diabetes.
10. Knowledge in Sclerostin (WNTsignaling inhibitor) may give an insight into the molecular mechanism relatedto WNT signaling pathway involved in the development of DM and itscomplications.